In order to obtain optimal exposure to a surgical site, after a surgeon has made an incision to a body, it is often necessary to use at least one retractor to expose the underlying layers of tissue.
Some existing surgical retractors include single bladed retractors, such as the Langenbeck retractor. The single bladed retractors are used to retract one side of a surgical incision in order to hold tissues clear of a surgical site. Such single bladed retractors must be continually held by an assistant or the surgeon and often multiple retractors are needed to retract skin, ligaments and muscle tissue around the incision, requiring both hands of the surgical assistant. Often these retractors are not self-retaining and thus continuous holding of the retractors by assistants is required. In such situations, the forces required to be exerted on the retractors can induce fatigue on the operators, particularly in lengthy operations, or for example, when operating on muscle-bound or even obese patients.
Thus, during a surgical procedure, a surgeon or the assistant will use one or more such single bladed retractors to expose the area that is to be operated on. The surgical assistant uses the retractor to keep the exposed area open. More than one single bladed retractor can be used in operations where more retraction is desirable for optimal surgical exposure.
Other handheld-type retractors include those that work on a scissor action in that the fingers of the operator are gripped through ring-shaped handles in order to move blades attached to levers inwardly and outwardly about a pivot point. Generally, they include a self-retaining mechanism in order to keep the blades apart at a set distance within the wound or surgical site. Specific problems with scissor action retractors are that an excessive amount of force may have to be applied in order to retract the levers and therefore the blades at the surgical site, and that the maximum extension or retraction may still not provide enough access for a surgeon to operate within.
Other retractors include multiple blades that can be separate from the retractor body or are attached to the retractor body by sliding arms. These retractors are typically locked into place by a butterfly nut, and for those that have separate blades, use the tension of human tissue to retain its place on the body of the retractor. Some of these self-retaining retractors are attached to a frame which is then attached to the surgical table or bed. These types of retractors are bulky, expensive and can be difficult and time consuming to set up.
Document WO03/017847 discloses an axillary clearance surgical device which has a pair of pivoting arms movable relative to each other and adapted to hold apart sides of a surgical incision. It also includes a substantially L-shaped retractor which is releasably mounted to a retaining element 14. The device is generally mounted to a support arm which is secured to an operating table during a surgical procedure. This is done to maintain the device in a desired position. The retractor disclosed in this document does not provide for hand-held use but instead requires connection through a support arm to the operating table for specific axillary clearance surgery.
In U.S. patent application No. 2004/225196 there is disclosed a surgical retractor consisting of a complex series of components in which the angular position of a pair of blades is adjustable by means of a pair of wires that extend from the blades to an adjustment screw located near the handles. There is no disclosure in this document of a pair of handles that can be rotated towards each other to thereby separate arm members and blades located at respective ends of the arm members when used in a surgical procedure to retract and hold apart tissue, without the use of adjustment wires.
In document WO2007/068128 there is disclosed a pair of tongs including a pair of handles and blades and a locking mechanism that includes a release member which allows the locking mechanism to be disengaged from a desired retracted position. Applying pressure to the handles separates the blades in a scissor-like manner in order to attract tissue. Furthermore, the handles are resiliently spread apart when the locking mechanism is disengaged.
In U.S. Pat. No. 6,283,913 there is disclosed a lid speculum that is used to retract an eyelid of an eye and has a pair of blades that are arranged to move in a radial direction corresponding to the shape of the eyeball. The device is suited only for eyelid retraction and is not applicable to retract tissue at a surgical site.
The present invention seeks to overcome one or more of the above disadvantages by providing a surgical retractor that can be held in one hand by the operator and can be used for an extended period of time during a surgical procedure. The surgical retractor of the present invention is made easier to use by an operator in that it uses a pivoting action when handles of the retractor are forced towards one another in order to spread apart respective blades of the surgical retractor. The present invention can allow a surgical assistant to retain a free hand for other tasks, such as retracting, cutting or clamping. It also provides the potential to allow for a relatively small incision by enabling better access to deeper tissues around the apices of the incision.